MANDATORY COVERAGE IS EASIER SAID THAN DONE

June 11, 2007

Requiring people who can afford health insurance to buy it -- the same way that car owners must buy auto insurance -- is easier said than done, says the New York Times. Massachusetts has spent the past year dealing with questions about how much basic coverage people need and how much they can be expected to pay (the state's poorest residents receive free or subsidized coverage).

The Massachusetts plan asks something of corporations, the state and individuals:

Companies with 11 or more workers that do not offer insurance to their employees are required to help finance the program by paying $295 a year for each worker.

The state provides money from its Medicaid program and some of the hundreds of millions of dollars it normally pays hospitals and clinics each year for care for the uninsured.

Forcing people to buy coverage can be difficult, especially when some people do not think they need it:

Almost half of the roughly 400,000 uninsured people in Massachusetts are single males, and many are young men.

Because young males are generally healthy, adding them to the pool of insured would most likely reduce the average cost of coverage over all, given that this particular group is not liable to need expensive treatment.

The goal is to generate a market where insurers offer affordable coverage to attract not only these young males but also people who otherwise could not pay for it. The law imposes a fine ($219 the first year and up to half the cost of premiums for the least-expensive policy in 2008) if proof of coverage cannot be shown; residents receive a form to file with their state tax return.

Source: Reed Abelson, "Mandatory Coverage Is Easier Said Than Done," New York Times, June 11, 2007.